title: Administrative issues to ensure safe anesthesia care in the office-based setting.
abstract: OBJECTIVE
  Office-based practice is distinct from other ambulatory practices and has unique considerations for an effective administrative structure to support its operations.
  
  
  RESULTS
  National guidelines have been promulgated by various entities addressing both management and clinical care aspects of the practice. Specific regulations vary by practice location, and practitioners need to comply with the pertinent accreditation and licensing requirements. Anesthesiologists have been at the forefront of promoting the culture of safety in the office-based setting. Specific practice considerations include provider credentialing, maintenance of documentation, quality assessment, professional liability, facility safety, patient health information, billing, and finance. Although there is emerging literature linking office accreditation to improved patient outcomes, more work is needed in this area.
  
  
  CONCLUSIONS
  Office-based practice will continue to evolve with the national emphasis on patient safety, cost reduction, value-based care, and outcomes measurement and reporting. Each practice must comply with the state and national regulations that could limit the types of procedures being performed and who can administer sedation or anesthesia, and require the facility to be accredited by a nationally recognized accrediting agency.
authors.affiliation: aDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School bDepartment of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Gaulton
authors.forename: Fred E
authors.initials: FE
authors.lastname: Shapiro
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000068:Accreditation; D000556:Ambulatory Surgical Procedures / Q000379:methods / Q000592:standards*; D000758:Anesthesia / Q000379:methods / Q000592:standards*; D006801:Humans; D061214:Patient Safety